The Relationship between Societal Stigma and General Self-Efficacy in Adults with Self-Reported Mental Health Conditions: A Serial Mediation Analysis

People with serious mental illness (SMI) are often troubled by societal stigma and subsequent processes, including self-stigma and lowered self-efficacy. Previous studies have observed the interrelationship among social stigma, general self-efficacy, psychiatric symptom severity, and self-stigma. Yet, it is warranted to examine the processes through which social stigma can hamper self-efficacy. This cross-sectional cohort study aimed to examine symptom severity and self-stigma as potential mediating factors between societal stigma and general self-efficacy. Three hundred working-age adults with self-reported SMI completed a Qualtrics survey that consists of measures of interested variables. Serial mediation analyses were used to examine the relationship. Symptom severity and self-stigma fully mediate the relationship between societal stigma and general self-efficacy. The implications of these results are that mental health professionals can target self-stigma and symptom severity to mitigate the negative effects of social prejudice and discrimination on general self-efficacy.

This is a pre-copyedited, author-produced version of an article accepted for publication in The Journal of Nervous and Mental Disease. The published version of record [The Relationship Between Societal Stigma and General Self-Efficacy in Adults With Self-Reported Mental Health Conditions. The Journal of Nervous and Mental Disease 213, 6 p117-123 (2025)] is available online at: 10.1097/NMD.0000000000001829.